The Correlation Of Serum Levels Of Vaspin, APN And LEP In Type 2 Diabetes Patients With Diabetic Retinopathy

Objective:To study the level changes of serum visceral adipose tissue-derived serine protease inhibitor(Vaspin),adiponectin(APN),and leptin(LEP)in patients with type 2 diabetic retinopathy and related situations,providing a new idea for early detection,diagnosis and management of diabetic retinopathy(DR)in clinic.Methods:Forty patients with type 2 diabetes without retinopathy who were hospitalized in the Endocrinology Department of the First Affiliated Hospital of Hebei North University from March 2022 to September 2022 were selected as the DM group and forty patients with type 2 diabetic retinopathy as the DR Group.General data of each subject were collected.Including sex,age,course of disease,systolic blood pressure(SBP),diastolic blood pressure(DBP),and body mass index(BMI).At the same time,fasting blood glucose(FPG),hemoglobin A1c(Hb Alc),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),Vaspin,APN,LEP and homeostasis model assessment insulin resistance(HOMA-IR)were evaluated by homeostasis model.Forty healthy subjects who came to our hospital for physical examination during the same period were selected as control group(NC group).Spearman correlation analysis was used to evaluate the correlation between Vaspin,APN,LEP and other indicators,and Logistic regression analysis was used to evaluate the influencing factors of type 2 diabetic retinopathy.Receiver operating characteristic curve(ROC curve)was used to evaluate the auxiliary diagnostic value of Vaspin,APN and LEP in type 2 diabetic retinopathy.Results:(1)Serum Vaspin and LEP levels in DR Group and DM group were higher than those in NC group,while APN levels were lower than those in NC group,and the difference was statistically significant(P< 0.05).Serum Vaspin and LEP levels in DR Group were higher than those in DM group,while APN levels were lower than those in DM group,the difference was statistically significant(P< 0.05);(2)Correlation analysis shows that:Serum Vaspin level was positively correlated with disease course,SBP,FPG,FINS,HOMA-IR and LEP,and negatively correlated with APN.Serum APN level was negatively correlated with course of disease,SBP,FPG,HOMA-IR,Vaspin and LEP.Serum LEP level was positively correlated with course of disease,SBP,FINS,HOMA-IR and Vaspin,and negatively correlated with APN;(3)Linear regression analysis shows that:All diabetic patients(DM group and DR Group)were taken as a whole,with the presence or absence of diabetic retinopathy as the dependent variable,and Vaspin,APN,LEP and indicators of significant differences between groups as independent variables,Logistic regression analysis was performed.The results showed that course of disease,FPG,Vaspin and APN were independent factors affecting type 2 diabetic retinopathy,among which course of disease,FPG and Vaspin might be risk factors for DR,while APN might be protective factors;(4)ROC curve results show that:The area under the curve(AUC)of serum Vaspin and APN levels for predicting the occurrence of DR were 0.824 and 0.902,respectively,with sensitivity of 85% and 95% and specificity of 77.5% and 85%.Conclusion:(1)In this study,the serum levels of Vaspin and LEP in patients with type 2 diabetes and retinopathy were higher than those in healthy people,and the serum levels of APN were lower than those in healthy people;(2)In this study,Vaspin was positively correlated with LEP,negatively correlated with APN,and negatively correlated with LEP and APN;(3)This study suggests that the occurrence of type 2 diabetic retinopathy may be related to the longer course of type 2 diabetes and the higher values of FPG and Vaspin;(4)This study suggests that serum Vaspin and APN levels have certain predictive value for the occurrence of DR Disease.